A review conducted on behalf of APEMH by John Harris, British Institute of Learning Disabilities. A shorter version of this paper has been accepted for publication by the British Journal of Learning Disabilities.
The review is designed to:
• establish a conceptual framework for examining choice and empowerment by people with a learning disability • identify instruments and protocols which have been developed to promote choice and empowerment • describe how services evaluate the role played by key-workers and services in promoting choice and empowerment and identify any protocols or ‘diagnostic’ tools which have been developed • consider outstanding issues for research and practice including the development of additional instruments and protocols.
The European Convention for the protection of Human Rights and Fundamental Freedoms provides a formal code under fifteen headings giving rights to all citizens in the European Union. Although the Convention does not explicitly refer to ‘choice and empowerment’ the realisation of the these concepts are clearly implied in respect of rights covering ‘liberty and security’ ‘respect for private and family life’ and ‘freedom of thought conscience religion and ‘freedom of expression’. Similarly, the United Nations Standard Rules on the Equalisation of Opportunities for Persons with Disabilities (1993), includes 22 statements giving direction to national governments. Choice and empowerment are not specifically itemised among the 22 target areas, but they are clearly implied under headings such as ‘rehabilitation’ ‘support services’ ‘family life and personal integrity’.
The most direct appeal for services to promote choice and empowerment for people with a learning disability comes not from national and international declarations but from O’Brien’s interpretation of the philosophy of normalisation and social role valorisation. O’Brien includes the provision of opportunities to make meaningful choices among the five fundamental accomplishments which high quality services should seek to deliver: competence; community presence; community participation; respect and choice (O’Brien 1987)
It should be noted that that this review is only concerned with published instruments and protocols designed to promote choice and empowerment. It does not consider broader approaches which have been developed to promote social understanding and increase confidence in social situations among people with a learning disability, for example advocacy groups or assertiveness training.
Information included in this review was collected in three ways:
• A search of the BILD Current Awareness Service data base • An advertisement in the Current Awareness Service Periodical (circulated to 500 subscribers throughout the UK and other countries) • An e-mail circular using selected contacts provided by the author(n=34)
The term empowerment as considerable intuitive appeal in so far as it has connotations with independence and assertiveness. However, it is difficult to define and it embraces numerous ambiguities, for example it refers to both a process and an outcome (Dempsey and Foreman 1997).
Baistow (1995) cites the definition offered by Adams 1990 as ‘the process by which individuals, groups and/or communities become able to take control of their circumstances and achieve goals, thereby being able to work towards maximising the quality of their lives’ (Page 35 in Baistow 1995). The relationship between the individual (psychological) aspects of empowerment and community involvement and participation has received considerable attention in the United States (see Dunst et al below). However, Baistow highlights some of the inconsistencies and contradictions which arise from this conceptualisation. For example, if empowerment is seen as the process by which power is...